How is cytomegalovirus primarily transmitted?

Cytomegalovirus (CMV) primarily spreads through direct contact with infected bodily fluids. This includes urine, saliva, semen, and blood, making option C the correct answer. The virus can be transmitted from an asymptomatic individual or from someone showing symptoms, especially during periods of active viral shedding. It's particularly relevant in situations like pregnancy, where the virus can be passed from a mother to her fetus, potentially leading to congenital infections and associated complications.

Other transmission routes listed, such as through contaminated water, respiratory droplets, or foodborne transmission, are not characteristic of CMV. While respiratory droplets may be a mode for other viral infections or illnesses, CMV is specifically known for its transmission through intimate or direct contact with infected secretions. Understanding these modes of transmission is crucial for public health strategies aimed at preventing CMV infection, especially in vulnerable populations like pregnant women and immunocompromised individuals.